Resilient Group Research Articles

Comorbid trajectories of posttraumatic stress disorder symptoms and depressive symptoms in a 10-year cohort of Chinese Wenchuan earthquake survivors: Course, predictors, and consequences.

Survivors may suffer mental health problems following disasters, particularly posttraumatic stress disorder (PTSD) and depressive symptoms. However, few studies have explored longitudinal processes of co-occurring PTSD and depressive symptoms among adolescent survivors and their associated predictors and consequences. The present study examines the codevelopment of both symptoms postearthquake using a 10-year cohort. A total of 1,357 senior high school students reported PTSD and depressive symptoms at 6, 12, 18, and 24 months after the 2008 Wenchuan earthquake. Self-report measures were also used to evaluate earthquake exposure, negative life events, social support, and trait resilience. At the 10-year follow-up (T10y), 799 participants reported their quality of life (QoL) online and 744 of them provided available data. A parallel-process latent class growth analysis was used to identify trajectories. Multinominal logistic and linear regressions were used, respectively, to analyze the predictors and consequences of these trajectories. Three comorbid trajectories were found: a resilient group (56.7%), a vulnerable group (33.3%), and a chronic high-risk group (9.9%). Gender, injury/missing/killed of family members, witnessing of traumatic sciences, negative life events, social support, and trait resilience were significant predictors of vulnerable and chronic high-risk groups. Finally, adolescents in these two groups were more likely to experience poorer QoL in adulthood. The results highlight the heterogeneity of depression-PTSD comorbidities among adolescent survivors. They also emphasize PTSD-depression symptoms predictors and their adverse impacts on life outcomes in adulthood. Individualized interventions should be provided for adolescents affected by natural disasters, especially those in the vulnerable and higher risk groups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Abstract 12747: Adaptive Coping, Resilience, and Cardiovascular Stress Reactivity in Women With Takotsubo Syndrome

Introduction: Takotsubo Syndrome (TS) is often triggered by acute stressful events. While excessive stress reactivity is associated with worse cardiovascular (CV) outcomes, its role and that of possible stress response moderators in TS are poorly understood. Goals/Aims: To explore whether adaptive coping and resilience affect CV reactivity in TS patients. Hypothesis: Negative psychological functioning will be associated with greater CV reactivity. Methods: Prospectively enrolled women with TS (per Mayo criteria) completed coping (Brief-COPE) and resilience (Brief Resilience Scale) measures at enrollment (scores categorized as “high” or “low” using a median split) and a standardized stress reactivity protocol 2 weeks later. Systolic blood pressure (SBP) and diastolic BP (DBP) (mmHg) were measured every 5 min during Baseline (10 min), Mental Stress (10 min), and Recovery (20 min) using an automated BP cuff. SBP and DBP change from baseline to peak stress and 5 min into recovery were compared between low vs. high coping and resilience groups, respectively, using t-test statistics; p < 0.05 was considered significant. Results: Patients (n=29; mean age 64.1 ± 8.8 years) with low (vs high) adaptive coping showed a smaller stress response (SBP: 15.9 ± 22.2 vs. 28.3 ± 19.2, p= 0.13; DBP: 8.1 ± 17.8 vs 21.8 ± 23.4, p= 0.11) and slower recovery (SBP -12.0 ± 7.0 vs -23.5 ± 19.3, p = 0.12; DBP -3.4 ± 17.6 vs -18.5 ± 22.1, p=0.07). Similar, non-significant responses were noted for the low (vs high) resilience group at peak stress (SBP: 18.8 ± 22.9 vs 27.9 ± 18.7, p= 0.28; DBP: 13.0 ± 20.9 vs. 16.9 ± 23.6, p=0.67) and recovery (SBP: -13.4 ± 17.4 vs -24.7 ± 19.3, p= 0.15; DBP: -5.3 ± 18.4 vs -18.3 ± 23.8, p= 0.16, Figure 1). Conclusion: Consistent with recent evidence in other populations, negative psychological functioning was associated with blunted CV reactivity in women with TS. Further investigation in fully powered studies is needed to confirm these novel, exploratory findings and their prognostic value.

Endocannabinoids, cortisol, and development of post-traumatic psychopathological trajectories

ObjectiveOur prior published work using the 2-factor model of PTSD identified four subgroups of trauma survivors on average 6 months following trauma: Resilient, Dysphoria, High Comorbid, and Severe Comorbid. Some findings indicate that low and high cortisol responses may increase risk for the development of PTSD and depression respectively, yet ways in which cortisol interacts with other physiological systems to enhance risk is unclear. This study examined the role of circulating eCBs in the development of previously identified psychopathological trajectories that is differentiated by cortisol in traumatically injured adults (N = 169). MethodsCirculating concentrations of eCBs, 2-arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA) were measured during post-injury hospitalization and on average 6 months following trauma. Differences in 2-AG and AEA among the subgroups were tested using multivariate ANCOVA. ResultsDysphoria (with highest cortisol levels) and High Comorbid subgroups exhibited higher post-injury AEA compared to the Resilient group. Dysphoria subgroup showed a significant decline in AEA by 6 months compared to Resilient and High Comorbid subgroups. ConclusionChange in AEA over time in individuals with high post-injury cortisol may serve as a buffer against risk for severe psychopathology. Assessing AEA and cortisol levels concurrently across time may serve as indicators of risk.

Association between Instagram addiction and well-being: the role of resilience and self-esteem

Abstract Background Instagram has become one of the most popular social media platforms worldwide, particularly among young adults. While social media use was found to impact negatively on mental health, few studies have focused solely on Instagram, and research on young adults’ positive mental health is still limited. Therefore, this study aims to explore the relationship between Instagram addiction, subjective well-being (SWB), and depression among college students, as well as investigate the moderating effects of resilience and self-esteem. Methods A total of 441 college students in Taipei, Taiwan participated in this study through convenience sampling between December 2022 and February 2023. Participants completed paper-based questionnaires that evaluated Instagram addiction using the Instagram Addiction Scale, SWB using items adapted from OECD Guidelines, and resilience and self-esteem using the Resilience Scale for Adults and Rosenberg Self-Esteem Scale, respectively. Data were analyzed using multiple linear regression. Results The sample consisted of 441 undergraduate students and the mean Instagram usage time was 67.4 minutes per day, and the mean addiction score was 27.3. After adjusting for potential confounders, Instagram addiction was negatively associated with life satisfaction (β=-0.06, 95% CI=-0.09∼-0.03), eudaimonia (β=-0.07, 95%CI=-0.12∼-0.03), and positive affect (β=-0.03, 95%CI=-0.05∼-0.01), and positively associated with negative affect (β = 0.05, 95%CI=0.03∼0.08) and depression (β = 0.16, 95%CI=0.12∼0.20). The correlation between addiction and mental health status was even stronger in the low resilience and low self-esteem groups. Conclusions College student with higher addiction to Instagram reported poorer mental well-being, with resilience and self-esteem showing moderation effects. Education on proper use and interventions promoting resilience and self-esteem are recommended to prevent the impacts of Instagram addiction on mental health. Key messages • Instagram addictions is associated with lower positive and worse negative mental health status. • Resilience and self-esteem are protective factors for the potential harm of Instagram addiction.

Association between rare earth elements and depression: Evidence from pilot mice model of chronic unpredictable mild stress-induced depression and human studies of major depressive disorder

The etiology of Major Depressive Disorder (MDD) has been associated with levels of trace elements in the human body. The source of trace elements in the human body may be rare earth elements (REEs). Our study aimed to identify the potential relationship between t REEs in blood and brain samples and depression from two paths: animal experiments and population studies. In the animal experiments, 35 adult Sprague–Dawley rats were randomly allocated to the control group (n = 14) and treatment group (n = 21), which received the chronic unpredictable mild stress (CUMS) procedure for four weeks and further categorized into the sensitive group (n = 9) and resilient group (n = 12) by sucrose water preference test. Then, all rats were executed to obtain serum and brain tissue samples. We also recruited 197 participants and divided them into the major depressive disorder (MDD) group (n = 100) and the control group (n = 97) then serum samples were collected for REEs detection. Our finding reported that significant differences were found in the levels of La and Ce in blood samples from different groups in the CUMS rat model (sensitive group < resilient group < control group) (all p < 0.05), with similar patterns for other elements (Pr, Nd, and Y) (but p > 0.5). No significant inter-group difference was reported in rat brain tissue samples. After adjusting for demographic variables, we found that the concentrations of all five REEs (La, Ce, Pr, Nd, Y) were lower in depression group than in control group (all p < 0.01). The current conjoint animal and human data supported appropriate levels of REEs have a certain protective effect on body health. These results may be attributed to Hormesis effects. Whether the possible favorable effects of REEs on improving symptoms of depression or can be applied to drug development remains to be further investigated.

Labour Resilience and Vulnerable Groups in Times of Crisis: A Comparative Study in Eleven European Countries

Abstract The financial crisis which hit the world economies in 2008 has had a negative effect across the spectrum of European economies. These impacts have been felt through the fall in economic activity and also by the deterioration of the labour market indicators. However, not all European markets have been hit with the same severity and intensity, causing territorial differences. But, beyond this, the crisis has had a clear impact on the labour force by exacerbating work inequality. Consequently, the concept of labour emerges through the adaptation of labour markets and the different results obtained amongst the collectives who make up the labour force. The present research has the dual goal of both describing and comparing the labour shock caused by the economic crisis in eleven European countries, establishing differences in employment outcomes of youth (15-24yrs of age), older (55-64yrs of age) and migrants workers by comparing key labour market indicators obtained from official statistical sources. Moreover, it reveals a documented analysis of various national reports describing the employment position of these groups. The results show similarities in the labour vulnerability patterns among countries in each of the groups studied. The analysis highlights the existence of certain factors linked to labour resilience of each group including economic, social, occupational, demographic and political factors. The results of this research are under the INSPIRES project, which has been funded by the Seventh Framework Programme of the European Commission.

Increased patient resilience scores are related to positive postoperative outcomes in rotator cuff repairs

We sought to determine whether patients' preoperative resilience scores predict postoperative outcomes in arthroscopic rotator cuff repair surgery. Patients were prospectively enrolled and underwent data collection preoperatively and at 3, 6, 12, and 24 months postoperatively. Data collected included demographic characteristics and the Brief Resilience Scale (BRS) score, visual analog scale score, Veterans RAND 12-Item Health Survey scores (mental component [VR-12M] and physical component [VR-12P]), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score, Single Assessment Numeric Evaluation score, and Simple Shoulder Test (SST) score. In total, 131 patients had complete 1- or 2-year postoperative outcome measures. Female patients comprised 56.5% of our sample, and the average age was 57.6 years. Between the low, normal, and high resilience groups, there were significant differences in the VR-12M scores at 0, 12, and 24 months postoperatively (P<.01 for all). The VR-12P scores at 12 months were 44.2, 47.4, and 49.8 in the low, normal, and high resilience groups, respectively, showing a trend upward, but this failed to reach the level of significance (P=.08). The SST scores of the low, normal, and high resilience groups at 12 months were 69.1, 79.9, and 85.1, respectively, again showing a trend upward, but this failed to reach the level of significance (P=.07). The SST scores at 0 and 24 months did not differ between groups. There were no significant differences in American Shoulder and Elbow Surgeons, visual analog scale, and Single Assessment Numeric Evaluation scores at 0, 12, or 24 months postoperatively. We found a significant positive correlation between the BRS score and SST score at 12 months (R=0.18), VR-12M score at 12 months (R=0.38), VR-12M score at 24 months (R=0.31), and VR-12P score at 12 months (R=0.21). Our study provides evidence that BRS scores in patients undergoing arthroscopic rotator cuff repair are related to postoperative outcomes, measured through the VR-12M and SST scores at 2-year follow-up.

Trajectories of cognitive reactivity and its predictive value on postpartum depression in Chinese women: a latent class growth modeling analysis

Many women are experiencing postpartum depression (PPD) after giving birth. How to recognize and intervene in high-risk PPD women early and effectively remains unknown. Our objective is to describe the latent trajectory groups of cognitive reactivity (CR) in perinatal women, and their relationship to demographic and disease-related factors, as well as investigate the associations with PPD. Data from 321 perinatal women who were evaluated in urban tertiary hospitals in China at three-time points: 32-35 weeks of pregnancy, 1 week postpartum, and 6 weeks postpartum. Latent class growth modeling was used to identify the trajectory patterns of CR and logistic regression was used to explore the association between demographic and disease-related factors, CR trajectories, and depression. Three trajectory groups were identified: the continuing deterioration group (17.2%), the postpartum deterioration group (22.1%), and the consistent resilient group (60.7%). Participants with a bachelor’s degree or higher and with gestational diabetes diagnosis were more likely to be in the continuing deterioration group. Those who were from only-child families were more likely to be in the postpartum deterioration group. Women in the continuing deterioration group and postpartum deterioration group were more likely to experience PPD. Targeted interventions should be developed based on trajectory group of CR.

Voluntary wheel running during adolescence prevents the increase in ethanol intake induced by social defeat in male mice.

Exposure to social defeat (SD) induces a depressive phenotype, increased ethanol seeking and consumption, accompanied by activation of the neuroinflammatory response. However, a resilient response can be potentiated through physical exercise in the form of voluntary wheel running (VWR) during or after exposure to social stress. Therefore, the aim of this study was to test whether physical exercise during adolescence prior to being exposed to SD can enhance resilience to the increase in ethanol intake. Male mice had access to VWR during adolescence and the effects of social defeat (4 sessions every 72h) on oral ethanol self-administration (SA) was evaluated. Based on the social interaction test, mice were classified as resilient or susceptible to depressive-like behavior. Two weeks after the last encounter, mice were subjected to the drinking in the dark and oral ethanol SA paradigms. Mice were then sacrificed to measure brain-derived neurotrophic factor (BDNF) levels in the striatum and hippocampus. As expected, susceptible mice increased ethanol intake in the oral SA protocol. However, susceptible mice in the exercise condition did not increase ethanol intake, showing similar consumption and motivation for ethanol than the control and resilient groups. On the other hand, decreased BDNF levels were observed in susceptible mice in both experimental conditions compared to the control groups after ethanol SA. The pre-exposure of VWR prevented the increase in consumption and motivation for ethanol induced by SD in susceptible mice. On the other hand, it appears that VWR did not exhibit any significant long-term effects on BDNF signaling, which is mainly affected in susceptible mice after ethanol intake.

Predicting secondary posttraumatic stress symptoms among spouses of veterans: Veteran's distress or spouse's perception of that distress?

There is a relatively wide consensus that veterans' posttraumatic stress symptoms (PTSS) may lead to the development of secondary traumatization (ST) among their spouses. However, there is limited knowledge about the way the ST develops over time, as well as its predictors. The current longitudinal study examined ST trajectories among spouses of Israeli war veterans with PTSS, as well as the contribution of veterans' PTSS and wives' assessment of veterans' PTSS to these trajectories. Data were collected from both spouses at 3 time points, 30, 35-37, and 42 years after the 1973 Yom Kippur War (2003, 2008-2010, and 2015, respectively). Using multiple-group Latent Class Growth Analysis (LCGA), we identified 4 distinct ST trajectories. The majority of wives (68%) were in the resilient group, 12% were in the recovery group, approximately 10% were in the chronic PTSS group and another 10% were in the delayed-onset group. Multinomial regressions revealed that veterans' PTSS predicted the 4 different trajectories among their wives. In addition, wives in the recovery and chronic groups who perceived their veteran husbands' PTSS to be higher also reported higher ST. This study highlights the complexity of the development of ST trajectories over time. Findings supports the idea of PTSS contagion, and reveals the contributing role of both objective and perceived levels of veterans' PTSS in ST. Therefore, implementing interventions aimed at alleviating both individual and couple-level distress may be warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

CAD/CAM indirect bonding trays using hard versus soft resin material: a single-blinded in vitro study.

The present in vitro study aimed to evaluate the accuracy of three-dimensional (3D) printed indirect bonding trays consisting of hard or soft resin materials produced using computer-aided design and manufacturing (CAD/CAM). Forty-eight dental casts were 3D printed. Four groups based on frontal crowding were defined and divided into hard- and soft-resin groups. After virtual bracket positioning on the digital models, the transfer trays were 3D printed. To evaluate the accuracy of the procedure, measurements were performed using a digital overlay of the virtual (target) bracket position and a post-bonding scan. The horizontal, transverse, and vertical deviations and angular discrepancies were analyzed. The loss rate was evaluated descriptively as a percentage. A total of 553 brackets were bonded using 24 soft and 24 resilient indirect bonding trays. The mean deviations were of 0.05mm (transversal), 0.05mm (horizontal), 0.09mm (vertical), 0.13° (angulation) in the resilient resin group and of 0.01mm (transversal), 0.08mm (horizontal), 0.08mm (vertical), 0.37° (angular) in the soft resin group. The loss rate was 6.9% and 0.7% in the hard and soft resin groups, respectively. Angular deviations were significantly higher in the soft resin group (P=0.009), whereas the loss rate was considerably higher in the hard resin group (P<0.001). The findings indicate that indirect bonding using CAD/CAM is an accurate procedure in the laboratory setting. Soft resins are considered favorable for loss rate and useability.

Differentiation of Hair Sheep Breeds Based on the Physiological and Blood Biochemical Changes in Response to Different Stressors Using Multivariate Analysis Techniques.

Physiological and blood measurement changes due to high heat load, restricted feed intake, and limited drinking water availability in 135 animals of three hair sheep breeds (Dorper, Katahdin, and St. Croix) were subjected to multivariate analysis techniques. The objective of this analysis was to evaluate the ability of these variables to separate individual hair sheep into groups based on adaptation characteristics in response to three physiological stressors and identify variables with greater discriminatory power. There were 16, 8, and 13 physiological and blood variables obtained from high heat load, restricted feed consumption, and water intake studies, respectively, for multivariate analysis. Physiological variables such as respiration rate, rectal and skin temperature, and panting score were measured only in the heat stress study. The results of the cluster and canonical discriminant analyses showed the presence of wide divergence (p < 0.05) between St. Croix and other breeds in their responses to high heat loads and restricted-feed- and -water-intake conditions. Dorper and Katahdin were grouped (p > 0.05) together based on the changes in physiological variables, which were separated (p < 0.05) from those of St. Croix as a resilient group. The stepwise discriminant analysis indicated that skin temperature, panting score, rectal temperature, respiration rate, and blood urea nitrogen and oxygen concentrations were the significant (p < 0.05) discriminating variables in clustering individual sheep into groups based on their responses to the high-heat-stress condition. Under the limited feed intake condition, the significant (p < 0.05) traits responsible for the separation of St. Croix from Dorper and Katahdin were blood triglyceride and cholesterol concentrations, whereas blood hemoglobin, osmolality, protein, and albumin were most important discriminating variables under the limited water intake condition. In conclusion, the results of the present study suggest that the stress responses of Dorper and Katahdin are similar and different from that of St. Croix. This finding can be useful information for future decisions in developing climate-resilient sheep through selective breeding.

Can resilience change over time? Patterns and transitions in resilience among young children involved with the child welfare system.

This study examined transitions in resilience profiles and the role of caregiver risk and protective factors in resilience transition probabilities over 18 months among children involved with the child welfare system, using latent profile analysis and latent transition analysis. The sample included 486 children (48% female, baseline Mage = 3.49). There were three resilience profiles at Time 1 (19.9% low emotional behavioral, 26.1% low cognitive, 54.0% multidomain) and two profiles at Time 2 (18.9% low emotional behavioral, 81.1% multidomain). Caregiver mental health problems were negatively associated with membership in the multidomain resilience group at Time 1. Higher levels of cognitive stimulation were associated with initial and continued membership in the multidomain resilience group. Implications for resilient child development are discussed.

Trajectories of parental posttraumatic stress disorder and children's mental health following Super Typhoon Lekima: The mediating role of feeling of safety.

Several studies have examined the impact of parents' posttraumatic stress disorder (PTSD) on their children's mental health, but few have evaluated the role of parents' specific PTSD trajectories. The aim of this study was to assess the mechanisms underlying distinct trajectories of parental PTSD that affect children's PTSD and depression through the feeling of safety. The final sample comprised 242 dyads of parents and their children who experienced Super Typhoon Lekima in 2019. All participants were surveyed at three time points after the typhoon: 3 months (T1), 15 months (T2), and 27 months (T3). Parental PTSD symptoms at three time points and children's PTSD, depression, and feeling of safety at T3 were analyzed. Four parental PTSD trajectories were identified: recovery, resilience, delayed, and coping. Compared with the resilient group, children of parents with delayed PTSD trajectories reported higher levels of depression at T3, while children of parents in the coping group were more likely to experience severe PTSD at T3. Children of parents in the recovery group, with a reduced feeling of safety, exhibited more severe depression and PTSD at T3, whereas children of parents in the delayed group were at an increased risk of PTSD at T3. These findings highlight the heterogeneity of parental PTSD trajectories following natural disasters and their distinct effects on children's PTSD and depression. Furthermore, feeling of safety emerges as a crucial mechanism in this process.

감사 프로그램이 지역아동센터 이용 아동의 감사성향, 회복탄력성, 학교 및 사회적응력에 미치는 효과

Objectives The purpose of this study is to validate whether a gratitude program, developed as part of the psychological and emotional support program for children utilizing community child centers, has a positive effect on the grateful disposition, resilience, school and social adaptability of the children. Methods This study analyzed the group differences in the levels of grateful disposition, resilience, school and social adaptability between the experimental group consisting of 53 participants who participated in the gratitude program, and the control group composed of 50 participants who participated in the existing psychological and emotional program, among children using community child centers. The levels of grateful disposition, resilience, school and social adaptability were measured before and after the intervention, and the analysis was conducted using the analysis of covariance (ANCOVA). Results The results of the analysis, controlling for the pre-test scores of the experimental and control groups, showed that there was a significant increase in grateful disposition, resilience, school and social adaptability among the children who participated in the gratitude program. Particularly, notable findings include a significant increase in resilience and significant group differences in various aspects. The gratitude program demonstrated a positive impact on grateful behaviors, peer relationships, social activities, as well as cooperation and stability. Conclusions The expansion of community child center programs, which have primarily focused on caregiving and basic academic support, to include psychological and emotional support programs has been emphasized. In this context, a gratitude program was developed, placing a stronger emphasis on a proactive form of the positive psychological element, gratitude. The gratitude program has been found to not only improve psychological factors such as grateful disposition and resilience but also enhance adaptive factors such as school and social adaptability.

Discordant Biological and Chronological Age: Implications for Cognitive Decline and Frailty.

Older adults with discordant biological and chronological ages (BA and CA) may vary in cognitive and physical function from those with concordant BA and CA. To make our approach clinically accessible, we created easy-to-interpret participant groups in the Health, Aging, and Body Composition Study (N = 2 458, 52% female participants, 65% White participants, age: 73.5 ± 2.8) based on medians of CA, and a previously validated BA index comprised of readily available clinical tests. Joint models estimated associations of BA-CA group with cognition (Modified Mini-Mental State Examination [3MS] and Digit Symbol Substitution Test [DSST]) and frailty over 10 years. The sample included the following: 32%, Young group (BA and CA < median); 21%, Prematurely Aging group (BA ≥ median, CA < median), 27%, Old group (BA and CA ≥ median), and 20%, Resilient group (BA < median, CA ≥ median). In education-adjusted models of cognition, among those with CA < median, the Prematurely Aging group performed worse than the Young at baseline (3MS and DSST p < .0001), but among those with CA ≥ median, the Resilient group did not outperform the Old group (3MS p = .31; DSST p = .25). For frailty, the Prematurely Aging group performed worse than the Young group at baseline (p = .0001), and the Resilient group outperformed the Old group (p = .003). For all outcomes, groups did not differ on change over time based on the same pairwise comparisons (p ≥ .40). Discordant BA and CA identify groups who have greater cognitive and physical functional decline or are more protected than their CA would suggest. This information can be used for risk stratification.

Interscalene Block Versus Periarticular Liposomal Bupivacaine for Pain Control Following Reverse Shoulder Arthroplasty: A Randomized Trial.

Interscalene nerve blocks and local anesthetic infiltration are two methods commonly used in multimodal analgesia regimens for shoulder arthroplasty. Liposomal bupivacaine is a novel anesthetic that can be detected more than 24 hours following local administration. Studies comparing liposomal bupivacaine with conventional analgesic methods have found mixed results regarding pain and narcotic consumption, and there is little information available regarding patient satisfaction and the role of psychosocial variables. This is a randomized study of 76 adult patients undergoing reverse shoulder arthroplasty who were assigned to receive a preoperative interscalene nerve block with ropivacaine (BLOCK=38) or an intra-operative periarticular injection of liposomal bupivacaine (LOCAL=38). The primary outcomes were narcotic consumption (MEq, morphine equivalents), visual analog scale (VAS) pain scores, and satisfaction (0-10). The secondary outcomes were the effect of patient group preference (BLOCK vs LOCAL) and psychosocial variables (Pain Catastrophizing Scale, Brief Resilience Scale) on satisfaction. Length of stay, pain related phone calls, pain related readmissions, and the number of narcotic refills were tracked from the day of surgery through the first postoperative appointment, which was routinely 7-14 days following surgery. Intraoperative and day 0 narcotic consumption was lower in the BLOCK group by 17.3 and 21.6 MEq (p < 0.001, p = 0.035) with no differences on day 1 or 2. There was no difference in VAS pain scores, length of stay, pain related phone calls, pain related readmissions, or the number of narcotic refills. Patient satisfaction was higher in the BLOCK group [8.3 vs. 6.8, p = 0.017]. Pain catastrophizing, resilience, and patient group preference did not have any significant relationship with patient satisfaction. Patients undergoing reverse shoulder arthroplasty have higher satisfaction with a conventional interscalene block compared to a periarticular injection of liposomal bupivacaine. There were no clinically important differences in narcotic consumption, VAS pain scores, length of stay, pain related phone calls, pain related readmissions, or the number of narcotic refills. The Pain Catastrophizing Scale, Brief Resilience Scale, and patient preferences did not have any relationship with patient satisfaction.

Poster 164: Impact of Patient Resilience on Rotator Cuff Repair Post-Operative Outcomes

Objectives: Patient resilience, defined by an ability to bounce back or recover from stress, was previously reported to correlate with outcomes after total shoulder arthroplasty. However, it is unclear whether this relationship exists for other orthopaedic procedures. This study sought to evaluate the relationship between pre-operative patient resilience and post-operative surgical outcomes in patients undergoing rotator cuff repair (RCR). Methods: Patients who underwent RCR in 2020 were identified from a single multicenter institution using CPT codes. Patients undergoing primary RCR who completed the Brief Resilience Scale (BRS) pre- operatively through our standard patient reported outcome data analysis were considered for inclusion. Patients with less than 2-year follow-up, irreparable rotator cuff tears, or significant concomitant surgery (ex: labral repair, capsular release for adhesive capsulitis) were excluded. A chart review was conducted to collect demographic variables including pre-operative sports participation, mental health conditions, rotator cuff tear size, and concomitant procedures. Two-year follow-up was collected, including the American Shoulder and Elbow Surgeons (ASES) survey, the Single Assessment Numeric Evaluation (SANE) survey, the BRS, and complications. Outcomes were compared between patients with low resilience (LR), normal resilience (NR), and high resilience (HR) as previously defined. Results: Overall, 156 patients were eligible for inclusion, and 100 patients (52 male, 48 female) with an average age of 60±9 years completed the follow-up survey and were included in this study. Patients in the LR group had significantly higher rates of anxiety and depression than patients in the NR and HR groups. Resilience scores were not constant over time, with 39% of patients switching resilience groups at 6-month follow-up and 38% of patients switching resilience groups at 2-year follow-up. Pre-operative ASES scores were significantly different between the groups, with the LR group having the lowest scores (35.0±19.1) and HR patients having the highest scores (53.6±20.1) (Table 1). There were no significant differences in post-operative outcomes between groups, including reoperation rate, ASES score, change in ASES score, and SANE score. Patients with higher pre-operative resilience without a history of anxiety and/or depression had improved SANE scores relative to patients with lower pre-operative resilience (p=0.019) (Table 2). Multivariate analysis found that resilience at 2-year follow-up was significantly related to ASES score improvement (estimate=6.41, p=0.031) (Table 3). Conclusions: Pre-operative patient resilience correlated with pre-operative ASES score, and resilience at 2-year follow-up correlated with ASES score improvement. When excluding patients with anxiety/depression, patients with low resilience were found to have worse post-operative SANE scores. Additionally, patient resilience was not static; over half of the patients with low pre-operative resilience were found to have normal or high post-operative resilience. [Table: see text][Table: see text][Table: see text]

Improvement of Academic Procrastination among High School Students through Psychological Resilience Group Counseling

High school students' academic pressure is heavy, and they are in the second accelerated period of physical development. Many behaviors in daily life need to consume self-control resources, so that their words and deeds can contribute to their long-term interests and meet the expectations of important others. For students, academic procrastination has become an extremely common existence in learning. At present, due to the large number of middle school students who procrastinate and the relatively insufficient number of psychological counseling teachers, individual counseling is far from meeting the needs of many middle school students, and group psychological counseling can just make up for this problem. Group career counseling can improve senior high school students' awareness of career planning, so that they can have a clearer understanding of themselves and the environment and make initial career decisions. This paper will analyze the current situation and causes of learning procrastination of senior high school students, and design and implement a group psychological counseling program in combination with the relevant theories of learning procrastination, so as to lay a foundation for further understanding the causes of learning procrastination of senior high school students in the future.

Student Adaptation, Loneliness and Mental Health Profiles during the Second Wave of the Pandemic COVID-19

Since the COVID-19 pandemic, adolescent mental health difficulties have increased. To understand adolescent adjustment, it is important to explore both mental health difficulties and indicators of resilience and well-being. The primary aim of this study was to explore the associations among resilience, subjective well-being (SWB), fear of COVID-19, and loneliness among adolescents during the second wave of the pandemic. Additionally, the study aimed to identify student profiles based on these variables. The sample consisted of 469 high school students (61% girls, 29% junior high school). Resilience was positively correlated with SWB and negatively with fear of COVID-19 and loneliness. Three student profiles were identified. The Resilient and Satisfied group (38%) consisted of students with the most positive adaptation, and the Average group (41%) involved students with middle scores in all variables, while the Vulnerable and Distressed group (21%) included those who struggled the most. The need for a tiered approach in providing school-based mental health support is discussed.